IMPACT: Increased Monitoring of Physical Activity and Calories with Technology

背景：由于青年中的严重肥胖(年龄≥120%的体重指数)一直在稳步上升， 密集的临床干预是必要的，这通常是在专门的儿童肥胖诊所提供的。 因为家庭环境和父母的行为模式是预测孩子的两个最强的因素 在行为减肥干预期间，以家庭为基础的治疗方法是必要的。这 策略在我们现有的、循证的儿科体重管理中取得了一定的成功 计划(Brenner Fit)，但由于Brenner Fit等计划依赖于计划的面对面交付 由于这些因素，提供的剂量受到登记接受治疗的家庭所经历的时间限制的限制。 因此，本研究的目的是提炼和试验定制的移动(MHealth)组件，以增强 现有的以证据为基础的儿科体重管理计划(Brenner Fit)以确定可接受性 从患者和临床工作人员的角度来看，可行性和相对于既定权重的经济成本 单独的管理协议[即，Brenner Fit与Brenner Fit+mHealth(Brenner MFIT)]。 主要目标1：完成对肥胖青少年的干预，包括播客/视频和 电子自我监测，以促进减少卡路里摄入量和增加体力活动。 主要目标2：对从一家儿科减肥诊所招募的二联体患者(n=40)进行干预试验，以 确定干预相对于标准护理的可接受性和可行性(n=40)。 次要目标：确定与开发和实施移动保健组成部分有关的费用 当与布伦纳健身计划一起提供时。 研究设计：在这个项目中，我们将随机选择80名肥胖青年(13-18岁)和一名照顾者(DYADS) 布伦纳拟合条件或布伦纳mFIT条件。所有参与者都将完成基线测量 在随机化之前，在三个月和六个月时。所有青少年参赛者将获得一份商业版的 活动监视器。护理者将收到播客，其中有一个关于护理者支持减肥的故事 儿童通过为其家庭提供健康食物/活动，包括健康饮食和体育活动 信息。儿童将收到包含健康饮食和身体活动信息的动画视频， 讲述一个儿童减肥的引人入胜的故事。所有参与者都可以访问网站和移动应用程序 在那里他们将跟踪自己(青少年)或他们的孩子(父母)的体重、饮食和体力活动。基于 他们的体重、饮食和体力活动报告，以及家属从临床工作人员那里收到的消息 将为促进健康的行为和克服感知到的障碍而量身定做。建议数 研究是创新的，因为它明确地将理论融入到干预和评估组件中 该项目并建立在现有关于使用移动技术的移动健康干预措施的文献的基础上。

Background: Since severe obesity in youth (BMI for age ≥120th percentile) has been steadily increasing, intensive clinical intervention is necessitated, which is often delivered in specialized pediatric obesity clinics. Since the home environment and parental behavioral modeling are two of the strongest predictors of child weight loss during behavioral weight loss interventions, a family-based treatment approach is warranted. This strategy has been moderately successful in our existing, evidence-based pediatric weight management program (Brenner FIT), but since programs such as Brenner FIT rely on face-to-face delivery of programmatic elements, the dose delivered is limited by the time constraints experienced by families enrolled in treatment. Therefore, the purpose of this study is to refine and pilot a tailored, mobile (mHealth) component to augment an existing, evidence-based pediatric weight management program (Brenner FIT) to determine acceptability from a patient and clinical staff perspective, feasibility, and economic costs relative to the established weight management protocol alone [i.e., Brenner FIT vs. Brenner FIT + mHealth (Brenner mFIT)]. Primary Aim 1: Finalize an intervention for adolescent youth with obesity, consisting of podcasts/videos and electronic self-monitoring, to promote reduced caloric intake and increase physical activity. Primary Aim 2: Pilot the intervention in dyads (n = 40) recruited from a pediatric weight loss clinic, to establish acceptability and feasibility of the intervention relative to standard care (n = 40). Secondary Aim: To establish costs associated with development and implementation of mHealth components when delivered with the Brenner FIT program. Study design: For this project, we will randomize 80 youth with obesity (13 – 18yrs) and a caregiver (dyads) to the Brenner FIT condition or the Brenner mFIT condition. All participants will complete baseline measures prior to randomization, and at three and six months. All youth participants will receive a commercially available activity monitor. Caregivers will receive podcasts with a story about a caregiver supporting weight loss in a child by providing healthy foods/activities for his/her family, including healthy eating and physical activity information. Children will receive animated videos that contain healthy eating and physical activity messaging, with an engaging story of a child losing weight. All participants will have access to a website and mobile apps where they will track weight, diet, and physical activity for themselves (youth) or their child (parents). Based on their reports of weight, eating, and physical activity, the messaging received from clinical staff by the families will be individually tailored to promote healthy behaviors and overcome perceived barriers. The proposed research is innovative in that it explicitly incorporates theory into the intervention and evaluation components of the project and builds upon an existing literature on mHealth interventions that use mobile technology.